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A helping hand

The precarious state of our ever-stretched NHS is never more obvious than in the winter months, but some innovative schemes are aiming to relieve some of the pressures in the year ahead.

Hot on the heels of Lord Ara Darzi’s report which warned the health service was in a “critical condition”, the Government’s 10 Year Health Plan is set to be published in spring 2025. It is based on three big shifts in healthcare; from hospital to community, analogue to digital, and sickness to prevention. While we wait for the details to be revealed, there are plenty of initiatives in and around the NHS which are already blazing some innovative trails in patient care – many of which make use of community pharmacy’s skills.

Move to community 

As part of the 10 Year Health Plan’s first shift ‘from hospital to community’, the Government wants to deliver plans for new neighbourhood health centres which will be closer to homes and communities. They will enable patients to see GPs, district nurses, care workers, physiotherapists, health visitors or mental health specialists, all under the same roof. 

With the NHS carrying out some 2.5 million tests and scans each month, yet still struggling to accommodate more than one in 20 patients who are waiting longer than the six-week target time to be seen, a solution that is working well has been the opening of community diagnostic centres in locations such as shopping centres, university campuses and football stadiums in a bid to increase testing capacity.

The national Community Diagnostic Centre (CDC) Programme is now in its fourth year and has approved 170 CDC sites across England, offering patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially expediting the start of treatment. CDCs should provide services for at least 12 hours a day, seven days a week. NHS England (NHSE) is saying its focus now is on the full opening and development of these sites so that they, along with new investment in acute imaging and endoscopy services, can deliver up to nine million tests each year by the end of 2024/25. 

Screening

More than 5,000 people in England have been diagnosed with lung cancer earlier thanks to an innovative NHS initiative which uses mobile scanning trucks to visit local communities. The biggest initiative in NHS history aimed at improving early lung cancer diagnosis, the NHS Targeted Lung Health Check Programme is specifically targeted at areas of the country with the highest rates of lung cancer.

The latest NHS data shows that 5,037 lung cancers have now been found through the programme since its launch in 2019, with more than three-quarters (76 per cent) of the lung cancers identified found at the earliest stages of one and two, when it is potentially curable. People diagnosed with lung cancer at these stages are nearly 20 times more likely to survive for five years than those whose cancer is caught late.

High street tests

Superdrug has launched a new Prostate Specific Antigen (PSA) blood test service across its nationwide high street health clinics, in a bid to encourage more men to check their prostate.

Despite prostate cancer being the most common cancer amongst men in the UK, many remain anxious, hesitant or embarrassed to see their GP for a Digital Rectal Examination (DRE). Superdrug’s new service (which costs £79) can help detect prostate cancer before symptoms develop and may pick up a fast-growing cancer at an early stage, where treatment is more likely to be effective. It works by measuring the amount of prostate specific antigen (PSA) in the blood, taken via a quick blood test administered by a nurse in one of Superdrug’s high street health clinics. 

Analogue to digital

In transforming the NHS from analogue to digital, the 10 Year Health Plan will create a more modern NHS by bringing together a single patient record, summarising patient health information, test results, and letters in one place, through the NHS App. It will put patients in control of their own medical history, meaning they do not have to repeat it at every appointment, and that clinicians also get the full picture of patients’ health.

The NHS App is now used by 34 million users to view records, book appointments and order prescription refills, but the NHS is adding new ways people can manage their health on their smartphone via the App. For example, women can make the most of cancer screening at the touch of a button with the rollout of a new ‘ping and book’ service that will send reminders to phones when they are due or overdue an appointment. The plans began with invitations for breast screening being sent directly through the NHS App and will be expanded to include cervical screening in Spring 2025, with new functionality being developed to enable millions to book screening through the App this year.

“Virtual wards (also known as hospital at home) allow patients to get hospital-level care in the safe and familiar surroundings of their own home”

Wider records access

New laws are set to be introduced to make NHS patient health records available across all NHS trusts, GP surgeries and ambulance services in England – speeding up patient care, reducing repeat medical tests and minimising medication errors. Systems will be able to share data more easily, saving an estimated 140,000 hours of NHS staff’s time every year. With quicker access to patient data, staff can spend more time face-to-face with patients.

In the meantime, Well Pharmacy has partnered with the Greater Manchester (GM) Care Record, granting over 60 Well Pharmacy locations access to vital health and social care data. The GM Care Record provides the full picture of care across multiple services, giving community pharmacists the data to make better-informed decisions regarding prescribed medications or referrals. The access enables them to quickly identify potential drug interactions and contraindications, resulting in safer prescribing and dispensing processes.

This access to vital patient information aims to support greater efficiency within pharmacies, reducing pressure on both pharmacists and GP practices, as there is no need to call or email colleagues in primary care, or any health services across Greater Manchester. 

Virtual wards

Virtual wards (also known as hospital at home) allow patients to get hospital-level care in the safe and familiar surroundings of their own home, freeing up hospital beds for patients who most need them. Providers of these services can be from acute, community and primary care sectors including community pharmacy teams. Patients are reviewed daily by the clinical team and the ‘ward round’ may involve a home visit or take place via video. Many virtual wards also use technology like apps, wearables and other medical devices enabling clinical staff to easily check in and monitor the person’s recovery.

The NHS is set to increase virtual ward use as analysis shows that 9,000 hospital admissions have been avoided in the South East of England last year thanks to the initiative. It found that if the model is scaled up across England, 178,000 admissions could be avoided over the next two years, according to NHS analysis.

Sickness to prevention

By moving from sickness to prevention, the Government wants to shorten the amount of time people spend in ill health and prevent illnesses before they happen.

A successful example of this is community pharmacies and optical practices in Humber and North Yorkshire, which have working together to identify patients suitable for the Hypertension Case-Finding Service since July 2022 in a pilot which has recently been recommissioned until 31 March 2025.

Across the two areas, 126 community pharmacies and 36 optical practices have so far participated in the pilot, where opticians can refer patients that have been identified with raised blood pressure to a community pharmacy for the Hypertension Case-Finding Service. Once a referral has been received, the community pharmacy will take further blood pressure readings and may offer ambulatory blood pressure monitoring (ABPM) if appropriate as per the Hypertension Case-Finding Service specification.

The Humber and North Yorkshire Health and Care Partnership yearly report for the Optical Practice and Community Pharmacy Hypertension pilot shows that between September 2022 and September 2023, 278 interventions at the optical practices were carried out with 134 (48.2 per cent) of these cases being referred onwards to community pharmacies, and only six per cent of all cases being urgently directed onwards to general practices or emergency services.

The majority of these interventions were screened and resolved outside of general practice and emergency services, thus reducing potential additional pressures on the already engaged systems.

Caroline Hayward, professional development pharmacist at Community Pharmacy Humber, says the service has “demonstrated the positive value of collaboration between optical and pharmacy owners to improve patient outcomes by increasing awareness of the possible risks of cardiovascular disease and facilitating access to blood pressure checks”.

Social prescribing  

The NHS has been investing in social prescribing since the concept was championed in the 2019 NHS Long Term Plan, referring people to a range of activities and support services with the aim of boosting their health and wellbeing. 

One example is the Doncaster Green Social Prescribing, which enables pharmacists, GPs and community nurses in Doncaster to prescribe non-medical support to their patients – such as that offered by the Community Interest Company (CIC) Wildlings & Wellbeing, which aims to reduce social isolation and improve mental well-being through nature connection and social engagement, by providing accessible and inclusive outdoor sessions at locations throughout the Doncaster borough. Activities include woodcraft, forest bathing, and therapeutic gardening. 

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